|For Renal Function Tests Explained|
A comprehensive examination of the renal tracts should always include
|Coronal scan plane for the Right Kidney
||Longitudinal: Normal Kidney
|Scan plane transverse kidney
||Transverse normal image
In the 1st trimester, the developing kidneys ascend in the foetal abdomen. If the progress is hampered, this can result in:
An interruption to the vascular supply to the developing kidney will result in an atrophic, poorly differentiated kidney.
|For a link to renal embryology
| For another link to renal embryology
|Horseshoe kidney: A transverse view across the midline showing the isthmus across the aorta.
||Horseshoe kidney: Longitudinal view of the horseshoe isthmus.|
|A sagittal view of the isthmus of a horseshoe kidney.
Also the result of abnormal or interrupted ascent during embryology.
|Cross fused ectopic kidney. The left kidney is fused to the lower pole of the right kidney.
The renal pelvis can project out of the hilum of the kidney without any obstruction or abnormality.
it will usually be isolated without any calycael dilatation.
It can be:
|A baggy extra-renal pelvis
To identify the cause of:
Highest frequency curved linear array probe possible. Start with 7MHz and work down to 2 or 3 for larger patients. Assess the depth of penetration required and adapt. Paediatric and thin patients should be scanned with a 7MHz. Good colour / power / Doppler capabilities when assessing vessels or vascularity of a structure.
Begin with the patient supine. Each kidney may also need to be examined in the decubitus position. Raise the ipsilateral arm above the patient's head.
A comprehensive examination of the renal tracts should always include assessment of the urinary bladder and, in males,the prostate.
Scan longitudinally right subcostally. Visualise the kidney inferior to the right lobe of the liver (RT), or spleen (LT). Place the probe between iliac crest and the lower costal margin to examine in the coronal plane. Ensure the kidney is thoroughly examined from edge to edge. Rotate into transverse. Scan from beyond the superior margin to inferior. Document the normal anatomy and any pathology found, including measurements and vascularity if indicated.
WHAT TO CHECK
A renal series should include the following minimum images;